The major argument for the use of instructive directives, such as a living will, is that it allows an individual to participate indirectly in future medical care decisions even if they become decisionally incapacitated, that is, no longer able to make informed decisions. Instructive directives may extend individual autonomy and help ensure that future care is consistent with previous desires. The living will was created to help prevent unwanted and ultimately futile invasive medical care at the end-of-life.


The major argument for the use of instructive directives, such as a living will, is that it allows an individual to participate indirectly in future medical care decisions even if they become decisionally incapacitated, that is, no longer able to make informed decisions. Instructive directives may extend individual autonomy and help ensure that future care is consistent with previous desires. The living will was created to help prevent unwanted and ultimately futile invasive medical care at the end-of-life.

When patients becomes incapacitated someone else will be required to make medical decisions regarding their care. Generally a spouse is the legal surrogate. If no spouse is available, the government typically designates the order of surrogate decision makers, usually other family members. In the United States this is determined by state law. By designating a DPAHC, the patient’s choice of a surrogate decision maker supersedes that of the government. In this way a person may name a friend as a surrogate decision makierinstead of a member of the person’s own family. A legal surrogate is particularly valuable for persons in non-traditional relationships or without a close family. The “proxy,” “agent,” or “surrogate” decision maker need not be a relative of the patient, though this person should have close knowledge of the patient’s wishes and views.